Correlates of low resilience and physical and mental well-being among black youths in Canada

Background Resilience has gained considerable attention in the mental health field as a protective factor that enables individuals to overcome mental health issues and achieve positive outcomes. A better understanding of resilience among Black youth is important for supporting the strengths and capacities within this population. This study seeks to investigate the correlates of resilience among Black youths in Canada. Methods The survey was conducted online through REDCap between November 2022 and March 2023. The Brief Resilience Scale (BRS) was utilized to measure the capacity of participants to recover from or bounce back from stress. The BRS comprises six five-point Likert scale items. Data were analyzed employing a bivariate analysis followed by a multivariable binary logistic regression. Results A total of 933 Black youths participated in the study across all Canadian provinces, of which 51.8% (483) identified as female and 46.7% (436) as male. Most respondents 51.3% (479) were between the ages of 16 and 20 years, with 28% (261) between the ages of 21 and 25 years, and 20.2% (188) between the ages of 26 and 30 years. In terms of employment, 62.0% (578) were working part-time, 23.7%, (220) were unemployed, and 9.8% (91) were working full-time. Over a third of participants (39.3%, 331) rated their mental health over the last month as good, with 34% (317) giving a rating of poor and 20.9% (195) giving a rating of fair. Black youths who were working part-time had four times greater odds of expressing low resilience (OR: 4.02; 95% CI: 1.82–11.29) than those who were not working. Black youth who ranked their mental health as poor were about nine times (OR: 8.65; 95% CI: 1.826–21.978) more likely to express low resilience. Conclusion In this study, the Black youth participants reported relatively low resilience scores. Employment, physical health, and mental health status were factors that contributed to low resilience. Further studies are needed to examine the causal link between resilience and its dynamic effect on health outcomes among Black youth. More interventions are needed to make mental health services accessible to Black youth in a more culturally sensitive way with cross-culturally trained professionals.


Introduction
Resilience refers to an individual's ability to adapt to adversity, trauma, or significant life stressors and recover.Resilience also plays a significant role in encouraging positive mental well-being and reducing the risk of mental health disorders among different populations [1].Resilience is predicated on the assumption that individuals have previously confronted unfavourable life situations and can leverage these experiences to effectively modify their behaviour [2][3][4].It is imperative to acknowledge that an individual may have resilience in a specific domain while lacking it in another; for instance, youth may exhibit satisfactory academic performance while concurrently experiencing symptoms of worry or depression [5,6].This implies the process of adaptation is influenced, at least in part, by the surrounding context.
Several studies [7][8][9] have used different terminologies to characterize the three resilience models, which essentially explain the same stress-related mechanisms for quality adaptation.They include the compensating model, the challenge model, and the immunity vs. vulnerability model's protective factor.According to O'Leary [7], the protective factor model of resilience describes how protection and risk factors interact to lower the likelihood of a bad result and attenuate the impact of risk exposure.This resilience model is based on systems theory and developmental literature.It suggests that despite adverse or unpleasant life conditions, these protective variables promote positive results and healthy personality traits [8,9].The ability to recover self-esteem, academic and professional skills, intrapersonal reflecting skills, emotional management abilities, planning abilities, life skills, and problem-solving abilities were among the protective factors found [9].
Generally, individuals in their youth have a range of psychological, emotional, and behavioural difficulties, particularly as they navigate the transitional periods between childhood, adolescence, and early adulthood [10].Several factors, such as multidimensional hurdles or life events, may expose young people to the possibility of acquiring a sense of discontentment with life.This, in turn, can result in significant health consequences.In the general population of youth, normal to higher levels of resilience are consistently associated with improved physical and mental health [11,12], with resilience possibly serving as a protective factor against the onset of chronic illness or depression [13].These findings suggest a potential causal association between higher levels of resilience and general well-being.A study focusing on young and older adults found evidence that resilience can be developed or maintained notwithstanding poor physical well-being [14].Such findings suggest that resilience may be utilized to enhance the health of youths and older populations.
Black youth are a unique population that often faces persistent stressors and other obstacles to resilience in the context of distinctive and complex issues.Black youth confront social, economic, and systemic challenges that might harm their mental health and well-being [15]; for instance, they face more discrimination, racism, social inequality, and restricted resources and opportunities than their white counterparts.According to Wyatt et al. [16], Black youth are disproportionately affected by mental health illnesses, including post-traumatic stress disorder, anxiety, and depression.These challenges might impact Black youth's academic achievement, social life, and overall quality of life.Black youth tend to adopt fearlessness, loss, or suppression of fear emotions in response to chronic and unpredictable trauma exposure and unresponsive support systems.However, life contentment can eradicate the symptoms of depression and generalized anxiety disorder (GAD) and boosts self-respect, confidence, and physical and psychological health among young people [17,18].Resilience also increases self-discipline [19,20] and promotes youth well-being and life satisfaction [21,22].Indeed, people with higher levels of resilience have fewer psychological issues [23]; a similar relationship has been found between resilience and physical health.Despite the fact Black youths are disproportionately exposed to stress that can increase their vulnerability to physical and mental health difficulties, existing mental health interventions fail to sufficiently cater to their specific needs [24].Black youth mental health treatment drop-out rates are high, and many standard treatments are less effective for Black youth than for other groups [24].Salami et al. [25] noted their Black youths participants held the belief that they are immune to mental health disorders and anticipated overcoming adversities through resilience.
Black youth physical and mental health is a major public health issue because it affects their development and life paths [26].This group faces unique adversities, such as systemic racism, social inequalities, discrimination, and limited access to resources, which can negatively impact resilience, physical health, and mental health [27,28].Black youth with stronger resilience may have better emotional regulation, problem-solving, and adaptive resilience skills, which in turn results in better mental health [29].Physical health is also an important part of well-being, and inequities in health outcomes among Black youth have drawn attention in recent years [30].
A better understanding of the impact of resilience on the physical and mental health of Black youth can inform targeted interventions and health promotion [31].The impact of systemic barriers is also important as these may be significant factors affecting the resilience, physical health, and mental health of Black youths [32].As such, this study aimed to assess the correlates and predictors of resilience and well-being of Black youths in Canada.

Study setting and sample size estimation
This study was conducted with Black youth living in Canada.According to the Canadian census (2021), a total of 1,547,870 Canadians identify as Black, constituting 4.3% of the total population [33].Data were collected using a proportionate-to-size sampling approach, which ensures the selection of a representative sample of Black youth from all 10 provinces and three territories of Canada.Black Youths who are between the ages 16 to 30 years, and who have lived in Canada for more than two years were included in the study.For our analysis, a 95% confidence interval and a margin of error of ± 3% required a sample size of 933.

Study design and institutional review board approval
This descriptive cross-sectional study employed selfadministered, anonymous, online questionnaires.Respondents who self-identified as Black youth living in Canada participated.The study was conducted in accordance with the provisions of the Declaration of Helsinki (Hong Kong Amendment).All participants were provided with an online information leaflet and informed consent was obtained before participation.The study received approval from the Health Ethics Research Board of the University of Alberta (Ethics ID: Pro00116630).

Data collection and outcome measures
The online survey was used to collect data from young Black people between the ages of 16 and 30 years who were living in Canada.This study utilized Research Electronic Data Capture (REDCap) electronic data capture tools for data collection and management.REDCap offers a user-friendly interface for capturing verified data, maintains an audit trail to monitor data manipulation and export activities, provides automated measures for continuous data downloads to popular statistical packages, enables data integration as well as compatibility with external sources, and ensures the security of data through its secure infrastructure [34,35].The data collection instruments used in this study drew upon relevant literature and previously validated instruments.The primary variables of interest were pertinent demographic data including age, gender, sexual orientation, education, and income as well as the Likert scale rating their physical and mental well-being including rating and resilience.
The standardized measure used to evaluate resilience was the Brief Resilience Scale (BRS), which assesses an individual's ability to bounce back or recover from stress [36].The BRS consists of six items measured on a fivepoint Likert scale.Responses are summed to provide a total score ranging from 6 to 30, from which the mean score is then calculated.A mean score from 1.00 to 2.99 indicates low resilience, from 3.00 to 4.30 shows normal resilience, and from 4.31 to 5.00 indicates high resilience [36].For analysis purposes considering a binary logistic regression, the scores were recategorized into two groups: normal to high resilience (≥ 3) and low resilience (< 3).The literature shows the BRS has good internal consistency, with Cronbach alphas ranging from 0.80 to 0.90 and test-retest reliability coefficients for a two-week interval of 0.61 to 0.69.A single-item measure of selfrated mental health (SRMH) was used in the assessment of physical and mental well-being.The item asks respondents to rank their mental health on a five-point scale (good to poor).In a study conducted by Fung et al., [37] it was found that the single-item SRMH measure is a reliable tool that is positively linked to self-esteem.However, it is negatively associated with common mental health symptoms such as depression and PTSD symptoms, as well as self-reported psychiatric treatment consumption.A subgroup of participants completed the retest after an average of 9.32 days (SD = 3.97).The single-item measure of SRMH showed moderate to good test-retest reliability with an ICC score of 0.75 (95% CI: 0.65-0.82,p < 0.001).These findings suggest that the single-item SRMH measure can be used as a public health measure to assess self-perceived general mental health.It reflects one's overall mental well-being and correlates with other mental health conditions such as depression and anxiety, as demonstrated in this study.

Statistical analysis
Data analysis was performed using SPSS [38].Demographic characteristics of Black youth, as well as responses to questions related to physical and mental well-being, were summarized by absolute numbers and percentages.Only completed responses were reported, with no data imputation.Chi-square and Fisher's exact tests with two-tailed significance (p ≤ 0.05) were conducted to examine the relationship between the demographic characteristics of Black youth and responses to questions related to physical and mental well-being.The demographic features of Black youths, along with their responses regarding physical and mental well-being, were presented in a concise manner using both absolute figures and percentages.The reported responses primarily consisted of completed data without any instances of data imputation.Analysis was performed using the chi-square or Fisher's exact test, with a two-tailed significance level set at p ≤ 0.05.The focus of this analysis was to examine the relationship between the socioeconomic background of Black youth and their responses to questions regarding their physical and mental well-being.
The variables that showed significance at the p ≤ 0.1 and approaching significance level in the bivariate analysis were included in the multivariable binary logistic regression analysis.This analysis aimed to investigate the probability of respondents exhibiting low resilience.The association between the predictor variables and the likelihood of low resilience was assessed using odds ratios.The analysis accounted for potential confounders in multiple logistic regression.
Table 2 shows the summary statistics of physical and mental well-being for the Black youth participants.Approximately 44% (377) of respondents rated their physical health over the last month as good, with 36.4% (307) giving a rating of poor and 18.9% (159) as fair.Less than half of the participants (39.3%, 331) rated their   3 illustrates the results of the bivariable analysis (p-values from chi-square and Fisher's exact test) of the association between the predictor variables and resilience.The prevalence of low resilience among study participants was 60.7% (558/919).Eight variables that were statistically significant at p < 0.05 (Relationship status; Religion; Annual income; How long have you lived in Canada?; Which language do you speak at home?; Rate your physical health in the last one month; Rate your mental health in the previous month; How many hours per night do you sleep on average per day?) and one at p < 0.1 (Are you currently a student?) were selected for the multivariable binary logistic regression model (Table 4).
The regression model comprised of 9/14 chi-square variables that predicted with one variable demonstrating marginal significance after removing six variables.
The logistic regression model Χ 2 of 30.95 (df = 8; n = 919) was statistically significant (p < 0.001), indicating the regression model could differentiate between Black youths who likely have low or normal to high resilience.The statistical model explained a range of variance from 15.1% (Cox and Snell R 2 ) to 24.8% (Nagelkerke R 2 ).A Hosmer-Lemeshow goodness-of-fit test indicated the model was properly fitted (χ 2 = 5.59; p = 0.99).Additionally, the model accurately classified 97.1% of the cases.No variables had a strong connection to other variables (r s > 0.7).The adjusted odd ratio controls for other predictor variables in the model.
Overall, Black youths who were working part-time had four times greater odds of expressing low resilience (OR = 4.02; 95% CI: 1.82-11.29)than those who were not working.Black youths who rated their physical health as fair over the last month had seven times greater odds (OR = 7.05; 95% CI: 3.715-14.29) of expressing low resilience than Black youths who rated their physical health as good.Black youths who rated their physical health as poor over the last month had 12 times greater odds of expressing low resilience (OR = 12.41; 95% CI: 1.106-15.385)than respondents who rated their physical health as good.Black youths who ranked their mental health as poor in the last month had more than eight times greater odds (OR = 8.65; 95% CI: 1.826-21.978) of expressing low resilience than those who rated their mental health as good.

Discussion
The findings of this study provide evidence of significant correlations between resilience, physical health, and mental health among Canadian Black youths.This study identified the type of employment as a predictor of low resilience among Black youth, with those working part-time being four times more likely to experience low resilience than Black youths who were not working.This finding is in line with studies with youth that report a significant interaction between type of employment, job demand, and resilience [39,40].Individuals exhibiting lower levels of resilience experience more unfavorable psychological and work-related outcomes, particularly in work environments characterized by low levels of pressure [41].Part-time work can increase stress and strain, affecting resilience and coping.A study on race, risk, and resilience and Black youth reported higher levels of racial socialization and well-being affected educational and employment levels, which in turn resulted in low levels of resilience; the study further indicated that 44% of its participants reported suffering from either physical and/or mental health issues [42].The higher risk of inadequate resilience among Black youth in the present study who worked part-time confirms that employment status affects resilience outcomes for this population.
Self-rated physical health and resilience among Black youths were also strongly correlated.Black youths who rated their physical health as fair or poor over the last month were far more likely (seven times and 12 times, respectively) to experience low resilience than Black youths who rated their physical health as good in the last month.This aligns with research that demonstrates physical health affects resilience outcomes [43,44].Black youths with fair or poor physical health may struggle to cope, which can lower resilience.To overcome hurdles and promote holistic well-being, resilience-building initiatives should take Black youth's physical health into consideration.
Black youth who ranked their mental health as poor in the last month were notably (nine times) more likely to experience low resilience compared to those who rated their mental health as good.This relationship between mental health status and resilience has also been noted in previous studies [29,44,45].Poor mental health reduces resilience to stress and adversity.Studies with youth show they are more likely to have lower community resilience if under 25 years of age [45]; this group can also exhibit considerable psychological impairments in response to disasters, with limited capacity for resilience compared to older adults [46].
Overall, the findings from this study are consistent with other literature on resilience in youth and well-being, including those with varied populations.A systematic review on this topic noted comparable connections Table 3 Bivariate analysis showing the relationship between variables and respondents' likelihood of low resilience between resilience, employment status, physical health, and mental health for racially and ethnically diverse youth [47].Such consistent findings across populations show the observed correlations are generalizable.

Study limitations
Data for this study were obtained through online surveys and cannot describe the entire population.Convenience sampling was used and biased respondents may selfselect into the sample.This study may have had different results if it had been conducted before the COVID-19 pandemic, which may have exposed participants to additional stress.Additionally, a unidimensional measure was used to analyze resilience in this study.The use of a multidimensional scale that distinguishes the roles of family and peers as protective factors linked with resilience may influence the overall score.

Conclusions
This study showed employment and physical and mental well-being contribute to low resilience among Black youth in Canada.Substantial relationships were noted between resilience and health outcomes, highlighting the need to understand and foster resilience in this vulnerable group.Black youth who worked part-time had much lower resilience than those who did not work.This underscores the need for supportive workplaces and skill development to build resilience among Black youths.
The relationship between self-rated physical health and resilience in Black youth was also clear.Low resilience was linked to fair or poor physical health.To improve resilience and well-being, Black adolescents should address physical health inequities and adopt healthy lifestyles.Not surprisingly.mental health and resilience were also linked in this population.Black youths with poor mental health had much less resilience.These findings emphasize the need for mental health support structures and resources in the Black community.Overall, our findings demonstrate that resilience is influenced by employment position, physical health, and mental well-being.These findings support resilience research on youth and emphasize the urgent need for holistic health programs that address both physical and mental well-being.
This study has important implications for policymakers, healthcare professionals, and community organizations trying to promote Black youth health in Canada.Understanding resilience variables helps create strategies and programs that support this population and improve health.This study sheds light on Black youth resiliency and physical and mental health in Canada.Initiatives to   promote holistic well-being and resilience-building should consider physical health as well as mental health.The findings also emphasize the need for customized therapies that address this population's particular issues.Improving resilience and addressing health determinants can improve the well-being of Black youth towards a more equal and inclusive society.Further studies are needed to examine the causal link between resilience and its dynamic effect on health outcomes among Black youth and also a need to understand more about Black youth's experience in the workplace with connections to economic challenges.

Table 1
Socio-demographic characteristics of the respondents (n = 933)

Table 2
Self-reported physical and mental well-being variables for the respondents (n = 933)

Table 4
Multivariable logistic regression model predicting the presence of low resilience among black youth